C10020885 / invoice 10000

REASON: D+
Nurse: -
Presented by: Andrea
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HOME CARE AND PREVENTIONS
Vaccinations: UTD
Nutrition: Lyka and life wise dry
Worming: Due Saturday
Hwp: -
Flea Treatment: -
CE: 
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SUBJECTIVE / HISTORY: 
Diarrhoea 5 days
Started after change to lykka turkey
Stopped Lykka yesterday and did just dry-no improvement-yoghurt consistency with some semi formed 
Yellow in colour with gel
Last night increased freqency
Good appetite
No vomiting 
Does eat stuff in garden
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CURRENT / ONGOING MEDICATION AND SUPPLEMENTS:
-
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OBJECTIVE / EXAM:
ASA Status (1-5): 1-2
BCS (1-9): 4-5
DS (0-4): 0

T: 37.5
P: 140
R: n

MM colour NAD
BAR
Abdomen slightly bloated caudally but relaxed on palpation
Normal skin tent
n : Normal     - : Not Examined
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ASSESSMENT: 
Problems:
Clinical exam unremarkable
Diarrhoea

Ddxi:
Dietary indiscretion,infection,other

Further Procedure & Diagnostic Needs [Client Response]:
Start on bland diet
Estimate for faecal testing-owner to drop in sample later today

Medication:
RC gastro diet-increased amount due to age
Pro kolin

Ongoing medication prescriptions? Renewed prescriptions: -
[a] = Appointment     [d] = Deferred     [w] = Waived     [x] = Do it now
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PLAN / CE: 
Await faecal sample results
Finalised by REC
Rec = Recall     Rev = Revisit     Rem = Reminder

CLIENT CONTACT:
O came in to buy Prime roll mentioned she has had some D+ last 24 hours. Advised check up as we are still quite young. O would like to try diet change first if still concerned tomorrow will book in

REASON: 2nd puppy vx
Nurse: SP
Presented by: Andrea
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HOME CARE AND PREVENTIONS
Vaccinations: C3 + KC vx due today
Nutrition: Life Wise Stage 1 + Lyka
Worming: IW
Hwp: Nil
Flea Treatment: Nil
CE: 
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SUBJECTIVE / HISTORY: 
Eating own faeces, otherwise EDUD normally
Shaking head after being in sand pit
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CURRENT / ONGOING MEDICATION AND SUPPLEMENTS:
Nil
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OBJECTIVE / EXAM:
ASA Status (1-5): 1
BCS (1-9): 4
DS (0-4): 0

T: 38.6
P: 120
R: n

APPEARANCE/DEMEANOUR: BAR
SKIN & COAT: n
EARS: n
EYES: n
ORAL: n, scissor bite
MM: Pink, moist
CVS: Normal rhythm
RESP: Lungs clear
ABDO/GIT: n
UROGEN: n
NEURO: n
MSK: n
LN: n
n : Normal     - : Not Examined
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ASSESSMENT: 
Problems:
Underweight

Ddxi:
-

Further Procedure & Diagnostic Needs [Client Response]:
Increase dry food for weight gain

Medication:
Fit for vaccination. 
Duramune C3 given s/c dorsal neck at the level of the shoulder blades.
Bronchishield KC given intranasally

Milbemax (x) to be given now
Nexgard Spectra (x) to be given at 12w of age

Ongoing medication prescriptions? Renewed prescriptions: -
[a] = Appointment     [d] = Deferred     [w] = Waived     [x] = Do it now
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PLAN / CE: 
Rem Final puppy vx at 16w of age
Finalised by ALX
Rec = Recall     Rev = Revisit     Rem = Reminder